“三阶段、七步法”案例引导教学在外科教学中的应用

Application of ＇ three phases and seven steps＇ case-based learning in surgical teaching

针对医学生学习曲线的特点，第二军医大学附属长征医院设计并实施了“三阶段、七步法”案例引导教学，分别在学生理论课学习阶段、第一轮实习和第二轮实习过程中实施，案例由单一系统、单种疾病到多个系统、多种疾病层次递进。每一次案例教学又分为确定学习目标，选择典型案例；学生自主研究案例，提出问题；小组讨论，确立共同问题；学生自主查阅资料，回答问题并准备汇报材料；集体授课，大组讨论；教师总结和课后评价七个步骤实施。在学生主动建构基础医学知识体系的过程中，保证了学生掌握基础医学知识的宽度、深度、系统性和完整性，逐步培养了其分析、解决临床实际问题的能力和临床科研能力。

In view of the characteristics of the learning curve for medical students, the ＇ three phases and seven steps＇ case-based learning model was designed and implemented by Changzheng Hos- pital, the Second Military Medical University. This model was carried out in the theoretical study stage, the first round of internship and the second round of internship. Cases of single diseases, multi- ple diseases involving variant systems and a variety of diseases involving different department were en- rolled for analysis and discussion. Implementation of each case study was divided in seven procedures ： determining learning objective and choosing typical case, studying case and raising questions, panel dis- cussions and establishment of common problems, looking up for information to answer questions and pre- paring report slide, large group discussions, summary and evaluation. ＇Three phases and seven steps＇case based learning model ensure the width and depth of basic medical knowledge learned by the students. With the practice of this model, the basic medical knowledge was constructed systemically and comprehensively by medical students. Students＇ abilities of problem-analyzing and problem-solving as well as clinical research were developed. This model was effective according to our practice and was worth spreading out.